Uvulopalatopharyngoplasty: The Naval Medical Center, Portsmouth, experience

Dunlevy, Timothy M.; Karakla, Daniel W.

doi:10.1016/s0196-0709(98)90084-9

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…11,12,21 Some studies in the literature have demonstrated higher success rates when the surgery was performed on patients with mild to moderate OSAS. 23,24 In the present study, patients with marked increase in AHI were those who benefited the most from the surgical treatment, probably due to the criterion selected for success. In patients with mild increase in AHI, a reduction <50% was considered as failure, when it is known that, for these patients, the control of clinical symptoms is a more important outcome than AHI, since presence of OSAS is only considered in patients with AHI < 15 per hour when associated with a clinical complaint.…”

Section: Discussionmentioning

confidence: 57%

New clinical staging for pharyngeal surgery in obstructive sleep apnea patients

Vidigal

Haddad

Cabral

et al. 2014

Brazilian Journal of Otorhinolaryngology

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The presence of hypertrophic palatine tonsils was the anatomical factor in common in the most successful stages (I, II, and V), regardless of body mass index. Although the modified Mallampati index classes 3 and 4 reduced the success rate of surgery in patients with hypertrophic tonsils (stage II), the presence of modified Mallampati index classes 1 and 2 did not favor surgical success in patients with normal tonsils (stage III).

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Section: Discussionmentioning

confidence: 57%

New clinical staging for pharyngeal surgery in obstructive sleep apnea patients

Vidigal

Haddad

Cabral

et al. 2014

Brazilian Journal of Otorhinolaryngology

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“…Another treatment is considered only if these patients do not adhere to or refuse CPAP use. Many studies have shown that obesity and severity of disease are limiting factors for the success of pharyngeal surgeries (24,25,27,28), a fact that often discourages surgeons from performing more aggressive pharyngeal procedures (especially uvulopalatopharyngoplasty) in these patients. On the other hand, we To + Uv Mean ± SD 36 ± 10 81 ± 26 23 ± 18 69 ± 0.14 83 ± 0.03 AHI = apnea and hypopnea per sleep hour index; Preop.…”

Section: Discussionmentioning

confidence: 99%

Obese obstructive sleep apnea patients with tonsil hypertrophy submitted to tonsillectomy

Martinho

Zonato

Bittencourt

et al. 2006

Braz J Med Biol Res

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The physiopathology of obstructive sleep apnea-hypopnea syndrome (OSAHS) is multifactorial and obesity has been shown to be one of the main factors correlated with its occurrence. In obese patients with anatomical alterations of the upper airways it is often difficult to predict success for surgical correction since obesity is a limiting factor. Therefore, the aim of the present study was to evaluate the results of tonsillectomy in a specific group of patients, i.e., obese OSAHS patients with tonsil hypertrophy. Seven OSAHS patients with moderate obesity with obstructive palatine tonsil hypertrophy were submitted to tonsillectomy. All patients were submitted to pre-and postoperative appraisal of body mass index, otorhinolaryngology examination and polysomnography. Patients' average age was 36.4 ± 10.3 years and average preoperative body mass index was 36.6 ± 6.3 kg/m 2 . Postoperative weight did not differ significantly from preoperative weight (P = 0.27). Average preoperative apnea and hypopnea index (AHI) was 81 ± 26/h and postoperative AHI was 23 ± 18/h (P = 0.0005). Average preoperative minimum oxyhemoglobin saturation (SaO 2 min) was 69 ± 14% and the postoperative value was 83 ± 3% (P = 0.038). In relation to AHI, 6 (86%) of the 7 patients studied showed a reduction of 50% in relation to preoperative level and of these, 4 (57%) presented AHI of less than 20%. Only one patient presented a reduction of less than 50% in AHI, but even so showed improved SaO 2 min. Tonsillectomy treatment for OSAHS in obese patients with obstructive palatine tonsil hypertrophy caused a significant reduction in AHI, with improvement in SaO 2 min. This procedure could be eventually considered as an option of treatment for obese OSAHS patients with significant tonsil hypertrophy when continuous positive air pressure therapy is not possible as the first choice of treatment.

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“…Im Rahmen der pra Èoperativen Diagnostik fu Èr diese Eingriffe hat sich die Kephalometrie bewa Èhrt [14,17]. Es werden bei diesen Operationsverfahren jedoch ungenu Ègende Langzeiterfolge und Rezidive beschrieben [1,4,10]. Bessere Erfolge konnten durch die Kombination mit Ver-a Ènderungen am kno Èchernen Gesichtsskelett erzielt werden [13,18,21].…”

Section: Introductionunclassified

Stellenwert der Radiokephalometrie in der Diagnostik bei OSAS im Erwachsenenalter. The Significance of Radiocephalometry for the Diagnosis of OSAS in Adults

Pradel

Schmidt

Paditz³

et al. 2000

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Zusammenfassung Untersuchungen zum Zusammenhang zwischen kephalometrischen und polysomnographischen Befunden wurden bisher von mehreren Autoren überwiegend mit linearen statistischen Methoden durchgeführt. Die eigene Arbeitsgruppe interessierte, ob durch den Einsatz mehrdimensionaler statistischer Verfahren der Informationsgehalt der Radiokephalometrie stärker ausgeschöpft werden kann. 77 Patienten mit OSAS (Alter 25 69 Jahre, RDI 3,6 90,1/h) wurden polysomnographisch und kephalometrisch untersucht. Die Vermessung der knöchernen Parameter erfolgte mit dem Computerprogramm WinCeph und die der Pharynxweichteile in Anlehnung an Hochban et al. (Dtsch Zahnärztl Z 49: 777 782, 1994). Mittels logistischer Regressionen wurde geprüft, ob polysomnographische RDI‐Werte > 20 aus dem Röntgenbild vorhergesagt werden können. Die Kopplung der 10 knöchernen Parameter ergab bezüglich der Erkennung erhöhter RDI‐Werte eine Sensitivität von 93 % bei einer Spezifität von 44 %. Vier Parameter fielen durch besonders hohe relative Risiken auf. Die alleinige Verwendung der Weichteilparameter zeigte eine Sensitivität von 98 % bei einer Spezifität von 13 %. Die gleichzeitige Betrachtung von Weichteil‐ und knöchernen Parametern erbrachte eine Sensitivität von 96 % bei einer Spezifität von 40 % in der Erkennung erhöhter RDI‐Werte. Die Radiokephalometrie gehört nicht zur Basisdiagnostik des OSAS, sie kann aber bei kieferchirurgischen Operationsentscheidungen einen Beitrag leisten.

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Uvulopalatopharyngoplasty: The Naval Medical Center, Portsmouth, experience

Cited by 6 publications

References 12 publications

New clinical staging for pharyngeal surgery in obstructive sleep apnea patients

New clinical staging for pharyngeal surgery in obstructive sleep apnea patients

Obese obstructive sleep apnea patients with tonsil hypertrophy submitted to tonsillectomy

Stellenwert der Radiokephalometrie in der Diagnostik bei OSAS im Erwachsenenalter. The Significance of Radiocephalometry for the Diagnosis of OSAS in Adults

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